The American journal of orthopedics
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The purpose of this study was to analyze the efficacy of femoral nerve blocks (FNBs) in decreasing postoperative narcotic use in adolescents undergoing patellar realignment surgery (PRS). All patients who underwent PRS at 2 children's hospitals between 1998 and 2002 were included in the study. ⋯ Total postoperative i.v. morphine use was statistically significantly different among the 3 groups: 9.0 mg for FNB, 26.43 mg for PRN-IV, and 64.7 mg for PCA. FNB use was effective in significantly decreasing postoperative i.v. narcotic use.
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When adequate fracture reduction cannot be achieved with closed techniques, internal fixation can restore anatomy and improve functional outcomes. Volar plating, dorsal plating, and radial plating are well-described techniques that are useful in isolation or in combination, depending on the specific fracture pattern. In this article, we review each of these techniques and provide case examples to illustrate their applicability.
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Successful treatment of pilon fractures requires a thorough understanding of the injury, proper timing of treatment, and use of the proper implant placed in the correct location. This article describes the factors involved in treatment decisions.